| NPI | 1477963452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP10049916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q8244) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2016-09-27 |